LILLY Testimonial Submission Form

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Your full name* This field is required.This information MAY be shared on print and/or digital promotions. Please see below for consent field.
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Your email* This field is required.This information will NOT be shared on print and/or digital promotions.
example@example.com
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Services received from LILLY Team or LILLY programs attended* This field is required.Programs/services may be those received or attended by a parent/guardian or child. Check all that apply.
Little LILLIES Early Learning Co-Op
Hybrid Homeschool Program
Academic Tutoring and/or Reading Intervention
Village in the Valley Monthly Parent-Provider Workshop
Village in the Valley Community Partner Network
Local Provider Referral and/or "Bridge" Support Services
Education Consulting, Choice Navigating, Academic Assessments, etc.
Other
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How would you rate your experience with LILLY Education Foundation, and the services received and/or programs attended?
Service/Program Quality
Communications with LILLY
Responsiveness from Team
Team Expertise & Professionalism
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Row 1, Column 0Row 1, Column 1Row 1, Column 2Row 1, Column 3Row 1, Column 4
Row 2, Column 0Row 2, Column 1Row 2, Column 2Row 2, Column 3Row 2, Column 4
Row 3, Column 0Row 3, Column 1Row 3, Column 2Row 3, Column 3Row 3, Column 4
Service/Program Quality
Communications with LILLY
Responsiveness from Team
Team Expertise & Professionalism
Row 0, Column 0Row 0, Column 1Row 0, Column 2Row 0, Column 3Row 0, Column 4
Row 1, Column 0Row 1, Column 1Row 1, Column 2Row 1, Column 3Row 1, Column 4
Row 2, Column 0Row 2, Column 1Row 2, Column 2Row 2, Column 3Row 2, Column 4
Row 3, Column 0Row 3, Column 1Row 3, Column 2Row 3, Column 3Row 3, Column 4
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Feel free to use this space to write as much or as little as you'd like to share about your family's LILLY story. We only ask that you please include names of any programs attended or services received from the LILLY Team and how it has impacted you and/or your family.* This field is required.
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Anything else you'd like to add?
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May we share your first name + the first letter of your last name in print and digital promotions?* This field is required.For example: "Jennifer M."
Yes
No
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By signing below, I acknowledge that I am granting permission for LILLY Education Foundation, Corp. to share my name*, the information shared, and testimonial provided across various print promotions and/or digital channels, including but not limited to: within marketing brochures, website(s) pages, email newsletters, social media posts, and for any other educational and/or promotional purpose and context judged appropriate at the organization's sole discretion. * This field is required.*If you have given LILLY permission to share this information.
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